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1.
Clin Diabetes Endocrinol ; 10(1): 18, 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38915129

RESUMO

Gestational Diabetes Mellitus (GDM) poses significant health risks to mothers and infants. Early prediction and effective management are crucial to improving outcomes. Machine learning techniques have emerged as powerful tools for GDM prediction. This review compiles and analyses the available studies to highlight key findings and trends in the application of machine learning for GDM prediction. A comprehensive search of relevant studies published between 2000 and September 2023 was conducted. Fourteen studies were selected based on their focus on machine learning for GDM prediction. These studies were subjected to rigorous analysis to identify common themes and trends. The review revealed several key themes. Models capable of predicting GDM risk during the early stages of pregnancy were identified from the studies reviewed. Several studies underscored the necessity of tailoring predictive models to specific populations and demographic groups. These findings highlighted the limitations of uniform guidelines for diverse populations. Moreover, studies emphasised the value of integrating clinical data into GDM prediction models. This integration improved the treatment and care delivery for individuals diagnosed with GDM. While different machine learning models showed promise, selecting and weighing variables remains complex. The reviewed studies offer valuable insights into the complexities and potential solutions in GDM prediction using machine learning. The pursuit of accurate, early prediction models, the consideration of diverse populations, clinical data, and emerging data sources underscore the commitment of researchers to improve healthcare outcomes for pregnant individuals at risk of GDM.

2.
Infez Med ; 32(2): 148-156, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38827826

RESUMO

Global efforts to combat epidemic cholera outbreaks have witnessed tremendous feats over the decades. However, sporadic outbreaks in regions, particularly across African states, mask these advancements. This regressive trend is frequently fuelled by factors retarding efforts towards optimal environmental sanitation and personal hygiene, which include ingesting infected food, drinking contaminated waters, and engaging in unhealthy environmental practices such as indiscriminate waste and sewage disposal and poor toilet practices. The ongoing efforts to achieve the Global Taskforce on Cholera Control (GTFCC) targets of a 90% reduction in cases and deaths by 2030, even in the wake of continuous outbreaks across various African regions, as reported by the World Health Organization (WHO) face a significant threat. One such effort, among others, is the AFRICHOL project, an enhanced cholera surveillance consortium launched in Africa over a decade ago as part of the GTFCC at WHO to monitor and fast-track the GTFCC's 2030 targets. It is tasked with supporting the implementation of research-based strategies for combating cholera in Africa. The prequalified oral cholera vaccines - Dukoral, Shanchol, and Euvichol - and those with recombinant DNA technology have also emerged as remarkable strides. In the face of this progress, challenges persist. Climate change, including extreme weather events and the lack of safe water, sanitation, and hygiene facilities, acts as a multiplier, amplifying existing challenges and hindering progress. Porous borders with inefficient disease surveillance networks among member states also facilitate the inter-territorial spread of the disease. Despite ongoing challenges, global targets are achievable provided strong institutional infrastructure and additional evidence-based public health initiatives are promulgated and enacted. The Global Roadmap to Ending Cholera Outbreaks by 2030 is a resourceful tool for advancing this fight and eradicating cholera.

3.
Medicine (Baltimore) ; 103(20): e38132, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38758856

RESUMO

Ovarian cancer, ranked as the second leading cause of gynecologic malignancy-related deaths globally, poses a formidable challenge despite advances in early detection and treatment modalities. This paper explores the efficacy and safety of mirvetuximab soravtansine, the first folate receptor alpha (FRα)-targeting antibody-drug conjugate, in platinum-resistant ovarian cancer expressing FRα. A review of 4 key studies involving 453 participants consistently demonstrates mirvetuximab soravtansine's clinically meaningful antitumor activity and favorable safety profile. Clinical implications emphasize mirvetuximab soravtansine's pivotal role in targeted therapy, especially for high FRα-expressing tumors, potentially reshaping platinum-resistant ovarian cancer management. The combination therapy approach introduces a novel dimension, suggesting enhanced therapeutic outcomes. Even in heavily pretreated patients, mirvetuximab soravtansine's favorable tolerability positions it as a viable option. The reliability of archival tissue for FRα assessment simplifies patient selection, streamlining accessibility to targeted therapies. However, identified gaps, including limited diversity in patient populations, sparse quality of life data, and the need for long-term safety information, indicate areas for future research. Exploration of additional biomarkers predicting mirvetuximab soravtansine responsiveness is essential for personalized treatment.


Assuntos
Anticorpos Monoclonais Humanizados , Resistencia a Medicamentos Antineoplásicos , Imunoconjugados , Maitansina , Neoplasias Ovarianas , Humanos , Feminino , Neoplasias Ovarianas/tratamento farmacológico , Maitansina/análogos & derivados , Maitansina/uso terapêutico , Maitansina/efeitos adversos , Anticorpos Monoclonais Humanizados/uso terapêutico , Anticorpos Monoclonais Humanizados/efeitos adversos , Imunoconjugados/uso terapêutico , Imunoconjugados/efeitos adversos , Receptor 1 de Folato , Antineoplásicos/uso terapêutico , Antineoplásicos/efeitos adversos
4.
Medicine (Baltimore) ; 103(15): e37747, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38608091

RESUMO

Mistreatment in medical education encompasses various forms of abusive behavior, often indicating a disregard for students' dignity and interfering with the learning process. This review paper aims to investigate the prevalence, patterns, and correlates of medical student mistreatment in Nigerian medical education and shed light on its impact on students' well-being. A literature search was conducted in August 2023 using Medline, Google Scholar, and Web of Science databases to identify relevant studies on the mistreatment of Nigerian medical students. Inclusion criteria encompassed all studies written in English, regardless of study design, while editorials, reviews, and opinion articles were excluded. Six studies with a total sample size of 1432 were included in the review. The review revealed high mistreatment rates, ranging from 46% to 91%, with verbal abuse being the most common form. Male students were more likely to experience mistreatment, while females had higher rates of sexual abuse. Perpetrators included male and female healthcare professionals, with consultants and resident doctors as common perpetrators. Age and study level were associated with mistreatment experiences. Consequences of mistreatment included emotional distress, depression, loss of self-confidence, academic disillusionment, substance abuse, and suicidal thoughts. Reporting rates were low due to a lack of awareness, fear of reprisal, and perceived futility. The findings underscore the need for institutions to create a supportive environment, raise awareness of available support systems, and implement policies to prevent mistreatment. Future research should focus on larger-scale studies with diverse samples and longitudinal designs to address limitations in the current literature.


Assuntos
Estudantes de Medicina , Feminino , Humanos , Masculino , População Negra , Bases de Dados Factuais , Nigéria/epidemiologia , Prevalência
5.
Health Promot Perspect ; 14(1): 3-8, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38623352

RESUMO

The healthcare industry is constantly evolving to bridge the inequality gap and provide precision care to its diverse population. One of these approaches is the integration of digital health tools into healthcare delivery. Significant milestones such as reduced maternal mortality, rising and rapidly proliferating health tech start-ups, and the use of drones and smart devices for remote health service delivery, among others, have been reported. However, limited access to family planning, migration of health professionals, climate change, gender inequity, increased urbanization, and poor integration of private health firms into healthcare delivery rubrics continue to impair the attainment of universal health coverage and health equity. Health policy development for an integrated health system without stigma, addressing inequalities of all forms, should be implemented. Telehealth promotion, increased access to infrastructure, international collaborations, and investment in health interventions should be continuously advocated to upscale the current health landscape and achieve health equity.

6.
Int J Gynaecol Obstet ; 166(2): 639-643, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38445529

RESUMO

Group B streptococcus (GBS) poses a significant threat to neonates, leading to morbidity and mortality. Intrapartum antibiotics, although effective, have limitations, prompting the exploration of maternal vaccination. This study reviews the current evidence for maternal GBS vaccination in the prevention of early-onset GBS disease in newborns. A search on Google Scholar, PubMed, and Scopus identified studies assessing the impact of maternal GBS vaccination on early-onset GBS disease. Inclusion criteria comprised English-language clinical trials or observational studies. Data extraction included study details, immunogenicity profiles, effectiveness, safety outcomes, and relevant findings. Qualitative synthesis was employed for data analysis. Five studies meeting the inclusion criteria were reviewed. Maternal GBS vaccines demonstrated efficacy with sustained immunogenicity. Adverse events, although documented, were predominantly non-severe. Variability in immune responses and maternal-to-infant antibody ratios show the need for tailored vaccination approaches. Long-term follow up and surveillance are essential to assess persistence and identify unintended effects. Positive outcomes in vaccine efficacy support GBS vaccination integration into maternal health programs. Implementation challenges in diverse healthcare infrastructures require tailored approaches, especially in resource-limited settings. Overcoming cultural barriers and ensuring healthcare provider awareness are crucial for successful vaccination.


Assuntos
Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez , Infecções Estreptocócicas , Vacinas Estreptocócicas , Streptococcus agalactiae , Humanos , Infecções Estreptocócicas/prevenção & controle , Feminino , Recém-Nascido , Vacinas Estreptocócicas/administração & dosagem , Vacinas Estreptocócicas/imunologia , Gravidez , Streptococcus agalactiae/imunologia , Complicações Infecciosas na Gravidez/prevenção & controle , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Vacinação
7.
Medicine (Baltimore) ; 103(5): e37154, 2024 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-38306573

RESUMO

Ovarian cancer presents a significant health challenge in sub-Saharan Africa (SSA), where late-stage diagnosis contributes to high mortality rates. This diagnostic gap arises from limited resources, poor healthcare infrastructure, and a lack of awareness about the disease. However, a potential game-changer is emerging in the form of liquid biopsy (LB), a minimally invasive diagnostic method. This paper analyses the current diagnostic gap in ovarian cancer in SSA, highlighting the socio-economic, cultural, and infrastructural factors that hinder early diagnosis and treatment. It discusses the challenges and potential of LB in the context of SSA, emphasizing its cost-effectiveness and adaptability to resource-limited settings. The transformative potential of LB in SSA is promising, offering a safer, more accessible, and cost-effective approach to ovarian cancer diagnosis. This paper provides recommendations for future directions, emphasizing the need for research, infrastructure development, stakeholder engagement, and international collaboration. By recognizing the transformative potential of LB and addressing the diagnostic gap, we can pave the way for early detection, improved treatment, and better outcomes for ovarian cancer patients in SSA. This paper sheds light on a path toward better healthcare access and equity in the region.


Assuntos
Neoplasias Ovarianas , Feminino , Humanos , Neoplasias Ovarianas/diagnóstico , África Subsaariana
8.
Medicine (Baltimore) ; 102(43): e35557, 2023 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-37904406

RESUMO

Cognitive impairment in individuals with diabetes represents a multifaceted and increasingly prevalent health concern. This review critically examines the current evidence regarding the intricate relationship between diabetes and cognitive decline. It highlights the existing knowledge on the impact of diabetes on cognitive function, spanning from mild cognitive impairment to dementia, including vascular and Alzheimer dementia. The review underscores the need for a standardized diagnostic paradigm and explores research gaps, such as the implications of cognitive impairment in younger populations and various diabetes types. Furthermore, this review emphasizes the relevance of diabetes-related comorbidities, including hypertension and dyslipidemia, in influencing cognitive decline. It advocates for a comprehensive, interdisciplinary approach, integrating insights from neuroscience, endocrinology, and immunology to elucidate the mechanistic underpinnings of diabetes-related cognitive impairment. The second part of this review outlines prospective research directions and opportunities. It advocates for longitudinal studies to understand disease progression better and identifies critical windows of vulnerability. The search for accurate biomarkers and predictive factors is paramount, encompassing genetic and epigenetic considerations. Personalized approaches and tailored interventions are essential in addressing the substantial variability in cognitive outcomes among individuals with diabetes.


Assuntos
Doença de Alzheimer , Transtornos Cognitivos , Disfunção Cognitiva , Diabetes Mellitus , Humanos , Estudos Prospectivos , Disfunção Cognitiva/etiologia , Doença de Alzheimer/diagnóstico , Transtornos Cognitivos/diagnóstico , Diabetes Mellitus/epidemiologia
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